NYS Barber Apprentice Form PDF Details

The New York State Department of State Division of Licensing Services provides a comprehensive framework for individuals aspiring to become barber apprentices through the Barber Apprentice Application process. This application serves as the initial step for those aiming to pursue a career in barbering under the guidance and supervision of a licensed barber, in accordance with New York State law (Article 28 of the General Business Law) and Departmental rules (19 NYCRR). To facilitate a streamlined and efficient application process, the Division of Licensing Services promotes the use of its online services, which not only expedite the application review but also grant applicants access to their license records and updates throughout the process. Applicants are required to provide an email address for electronic communications, highlight any changes to their Supervising Barber Operator promptly, and ensure the completion of a mandatory course on the transmission of contagious diseases, approved by the New York State Education Department. The application fee is set at $20, with a certificate validity of four years, and applicants must undergo a physical examination. Additionally, adherence to New York State's General Obligations Law necessitates the completion of a Child Support Statement, further emphasizing the state's commitment to responsible professional conduct. This comprehensive application process underscores the state’s dedication to maintaining high standards within the barbering profession, ensuring that apprentices are well prepared for their roles in promoting health and safety in barber shops across New York.

QuestionAnswer
Form Name NYS Barber Apprentice Form
Form Length 6 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 1 min 30 sec
Other names nys barber, renew barber license ny online, dos 1444 form, nys barber apprentice application

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New York State

 

DEPARTMENT OF STATE

 

Division of Licensing Services

 

P.O. Box 22001

Customer Service: (518) 474-4429

Albany, NY 12201-2001

www.dos.ny.gov

Barber Apprentice Application

For a faster and easier process, the Division of Licensing Services encourages applicants to apply online. Using online services provides a quicker turnaround time on your application and updates and it allows you to view and access your license records throughout the license process.

Visit our website at: www.dos.ny.gov

Please see the online section of these instructions for more information.

Why do I need to provide my email address on the paper application?

Your email address will be used to create your NYS License Center account. Most communications will be sent via email. If you change your email address in the future you will need to log into your account and update it with the new email address.

What if my Supervising Barber Operator Changes?

You need to notify the Division of Licensing Services of this change. On the department’s website, http://www.dos.ny.gov /licensing/, you may download the ‘Change of Supervising Barber for Barber Apprentice’ Form (DOS-1961). This assures your certificate of registration remains current with this department. There is no fee for this amendment.

Read the instructions carefully before completing the application. All fields are mandatory, incomplete applications will be returned, delaying licensure. Any omission, inaccuracy or failure to make full disclosure in an application or supporting documentation may be deemed sufficient reason to deny a license, or, if a license is issued could result in the suspension or revocation of a license.

What is a Barber Apprentice?

New York State law (Article 28 of the General Business Law) and Department of State rules (19 NYCRR) defines a barber apprentice as a person pursuing in good faith a course of study in the practice of barbering under the tutelage, supervision and direction of a licensee and who assists such licensee in such practice.

What qualifications do I need for a certificate of registration?

If you are at least 17 years old and will be working under the supervision and direction of a licensed barber, you may apply for a certificate of registration.

All applicants must complete a one time course of study regarding “the transmission of contagious diseases and the proper methods of sanitation and sterilization to be employed in barber shops.” The course must be approved by the New York State Education Department and proof of course completion must be submitted with this application.

What is the fee and term for a certificate of registration?

The application fee is $20. Your certificate of registration will be valid for four years.

What forms of payment do you accept?

You may pay by check or money order made payable to the Department of State. You may also pay by American Express, MasterCard or Visa, using a credit card authorization form or when applying online. Do not send cash. Application fees are nonrefundable. A $20 fee will be charged for any check returned by your bank.

Does the certificate of registration allow me to operate a barber shop?

No. A certificate of registration as a barber apprentice does not allow you to operate a business. To operate a business, you must be a licensed barber. To apply for a barber’s license based on an apprenticeship, you must have worked as a NYS-registered barber apprentice under the supervision of a NYS-licensed barber for two years.

Do I need a physical to be issued a certificate of registration?

Yes. You need to be examined by a physician or physician’s assistant to apply for an apprentice barber certificate of registration. Your physician or physician’s assistant must complete and date the Health Certification section of the application or Health Certification Form (DOS-1948) if you are

DOS 1444-a (Rev. 1/14)

Page 1 of 6

Barber Apprentice Application

applying online. You must submit your application within 30 days after it is signed.

Do I need to complete the Child Support Statement section of the application?

Yes, a Child Support Statement is mandatory in New York State (General Obligations Law). The law requires you to complete this Section - regardless of whether or not you have children or any support obligation.

Any person who is four months or more in arrears in child support may be subject to having his or her business, professional and driver’s licenses suspended. The intentional submission of a false written statement for the purpose of frustrating or defeating the lawful enforcement of support obligations is punishable under §175.35 of the Penal Law. It is a class E felony to offer a false instrument for filing with a state or local government with the intent to defraud.

Information on Online Services:

For a faster and easier process, the Division of Licensing Services encourages applicants to apply online. Using online services provides a quicker turnaround time on your application and updates and it allows you to view and access your license records throughout the license process.

For more complete instructions and other online information see

the FAQ’s at http://www.dos.ny.gov/licensing/lc-faq.html

What transactions and information are available online?

•Complete an initial application

•Check the status of an application

•Renew your license

•Schedule an examination and view the results

•Check the status of a license

•Amend license information

•Request a duplicate license

How do I register for an account within the NYS License Center (NYSLC)?

In order to register for an account within the NYS License Center (NYSLC), you must first register with My NY.gov.

If you are not currently registered with My NY.gov, from our website http://www.dos.ny.gov/licensing/licensecenter.html Click on the ‘Create my Account’ link, this brings you to the My NY.gov registration site; select ‘I need a NY.Gov ID’ and follow the registration for My NY.gov. Once you are registered with My NY.gov, select the NYS License Center option from the options available to you on My NY.gov. In the NYS License Center, click on the ‘Account Management’ link in the top right hand corner. Complete the required fields and this data will pre-populate on all

DOS 1444-a (Rev. 1/14)

new applications created using your account. Once you have completed and saved this data, click on the ‘Home’ tab to proceed.

What if I already have a My NY.gov Account?

If you are already registered with My NY.gov, go to My NY.gov and sign in, then select the NYS License Center option from the options available to you on My NY.gov. This will create your NYS License Center Account. In the NYS License Center, click on the ‘Account Management’ link in the top right hand corner. Complete the required fields and this data will pre-populate on all new application created using your account. Once you have completed and saved this data, click on the ‘Home’ tab to proceed.

How do I apply for a license in NYS License Center?

To apply for a license at NYS License Center, you must create an account or login to your existing account. Follow these steps to apply for your license online:

•Register for an Account or Login to your account (see “How do I register for an account within the NYS License Center (NYSLC)” above)’

•Once you are logged in to NYS License Center, on

the ‘Home’ tab select ‘Apply now for a new license or permit’

•Follow the application instructions provided online

•Upload any supporting documentation

•Make payment and print confirmation page

You will be able to log in to your account and view the status of your application.

How do I create an additional license online?

To apply for an additional license, login to your account and click on the ‘Manage My Licenses’ tab and then select the ‘Apply now! For a New License or Permit’ link. Read and accept the terms and conditions and the system will guide you from there.

What is my User ID for the online system?

When you create your account on My NY.Gov, you will create a unique user ID and use your email address. You will then be able to access your account via user ID.

How do I update my online account information?

There are two locations you are required to update your online account information. You need to update your data at My NY.gov and on your NYS License Center account.

At My NY.gov, see the FAQs for information on managing your account.

Login to your NYS License Center account, on the top row you will see a link titled ‘Manage My Licenses’. From there you will be able to update your account information by completing a contact change amendment.

Page 2 of 6

Barber Apprentice Application

I am applying online, how do I notify this department of my physical examination?

All applicants need to be examined by a physician or a physician’s assistant to apply for a license in Barbering. The license application must be submitted within 30 days after an examination by a physician or physician’s assistant, and must include their name and contact information on the application. The Health Certification form (DOS-1948) must be completed and can be downloaded from the Department of State website.

On your online application using NYS License Center, you must utilize the information contained on the completed Health Certification Form. You are required to enter information form this form into the health certification fields within the system.

Please note: This completed Health Certification Form is subject to audit by an investigator to ensure compliance with this requirement. Evidence of this form must be maintained on your work premises for audit purposes.

I am applying online, how will my Supervising Barber complete the Affirmation?

If your supervising barber has an online account through NYS License Center, they will receive an email with a pin number and instructions for completing the affirmation online. If your supervising barber does not have an account you will be instructed to upload the affirmation certification.

What if my Supervising Barber Operator changes?

You need to perform an online amendment transaction to notify NYS Department of State, Division of Licensing Services of this

DOS 1444-a (Rev. 1/14)

change in supervisor. This change may also be made by completing the form ‘Change of Supervising Barber for Barber Apprentice’ Form (DOS-1961) found on the Department of State website. This assures your certificate of registration remains current with this department. There is no fee for this amendment.

PRIVACY NOTIFICATION

Do I need to provide my Social Security and federal ID numbers on the application?

Yes. The Department of State is required to collect the federal Social Security and Employer Identification numbers of all licensees. The authority to request and maintain such personal information is found in §5 of the Tax Law and §3-503 of the General Obligations Law. Disclosure by you is mandatory. The information is collected to enable the Department of Taxation and Finance to identify individuals, businesses and others who have been delinquent in filing tax returns or may have underestimated their tax liabilities and to generally identify persons affected by the taxes administered by the Commissioner of Taxation and Finance. It will be used for tax administration purposes and any other purpose authorized by the Tax Law and may also be used by child support enforcement agencies or their authorized representatives of this or other states established pursuant to Title IV-D of the Social Security Act, to establish, modify or enforce an order of support, but will not be available to the public. A written explanation is required where no number is provided. This information will be maintained in the Licensing Information System by the Director of Administration and Management, at One Commerce Plaza, 99 Washington Avenue, Albany, NY 12231-0001.

Page 3 of 6

FOR OFFICE

APPLICATION NUMBER

FEE $20

USE ONLY

BA-A-____ - ______________

 

 

 

 

Barber Apprentice Application

NYS Department of State

DIVISION OF LICENSING SERVICES

P.O. Box 22001

Albany, NY 12201-2001

Customer Service: (518) 474-4429

www.dos.ny.gov

Read the instructions before completing this application. You must answer each question and PRINT responses in ink.

Applicant Information

First Name

 

Last Name

 

Middle Name

 

 

 

 

Suffix

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home Address (provide street number and street name)

 

 

 

Suite, Apt., Unit

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

 

Zip+4

 

 

County

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (provide PO Box here)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

 

Zip+4

 

 

County

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

E-Mail Address

 

 

Social Security Number

 

Federal Taxpayer ID

 

 

 

 

 

 

 

 

 

 

Date of Birth

Home Phone

Mobile Phone

 

 

 

Business Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

Background Data

YES or NO

1.Have you ever been issued either a New York State Barber license or Apprentice Barber Registration? ➔IF “YES,” check appropriate box and give License or Registration UID Number and expiration date:

□ Barber License Unique ID Number

UID #

 

Exp. Date

□ Apprentice Barber Registration Unique ID Number

UID #

 

Exp. Date

2. Have you completed an approved infection control course?

➔(NOTE: You are required to complete this course and must attach the original course completion certificate with this application.)

3.Have you ever been convicted in this state or elsewhere of any criminal offense that is a misdemeanor or felony?

➔IF “YES,” you must submit with this application a written explanation giving the place, court jurisdiction, nature of the offense, sentence and/or other disposition. You must submit a copy of the accusatory instrument (e.g., indictment, criminal information or complaint) and a Certificate of Disposition from the court. If you possess or have received a Certificate of Relief from Disabilities, Certificate of Good Conduct or Executive Pardon, you must submit a copy with this application.

4.Are there any criminal charges (misdemeanors or felonies) pending against you in any court in this state or elsewhere?

➔IF “YES,” you must submit a copy of the accusatory instrument (e.g. indictment, criminal information or complaint) from the court.

DOS 1444-a (Rev. 1/14)

Page 4 of 6

Barber Apprentice Application

YES or NO

5.Has any license or permit issued to you or a company in which you are or were a principal in New York State or elsewhere ever been revoked, suspended or denied?

➔IF “YES,” you must submit a copy of all relevant documents, including the agency determination, if any.

An apprentice must work under the supervision and direction of a licensed barber. Your supervising barber must complete the following:

Affirmation of Supervising Licensed Barber

Supervising barber name

Supervising barber operator license Unique ID Number*

Barber shop name

Barber shop license Unique ID Number*

* The License Unique ID Number is found in the upper left corner of the license certificate

I, the undersigned, subscribe and affirm under the penalties of perjury, that the named applicant will be under my supervision and direction for the 24-month apprenticeship as provided under provisions of the General Business Law (Article 28).

Supervising Barber’s

Signature

X

 

Date

Health Certification — You must submit this application within 30 days after your physical examination.

I am a duly licensed physician or physician assistant and in the course of a routine examination of the person named on this application on (Date of Physical Examination), I found no clinical evidence of the presence of infectious or communicable disease which would pose a significant risk or direct threat to the health or safety of members of the public in the conduct of

the applicant’s occupation.

Print Name of Physician

Address of Practice

Physician’s Signature

 

Date

* Signature of a Nurse Practitioner is not acceptable

 

Child Support Statement — You must complete this section. If you do not complete it, your application will be returned.

“X” A or B, below

I, the undersigned, do hereby certify that (You must “X” A or B, below):

A.[ ] I am not under obligation to pay child support. (SKIP “B” and go directly to Applicant Affirmation).

B.[ ] I am under obligation to pay child support (You must “X” any of the four statements below that are true and apply to you): [ ] I do not owe four or more months of child support payments.

[ ] I am making child support payments by income execution or court approved payment plan or by a plan agreed to by the parties.

[ ] My child support obligation is the subject of a pending court proceeding. [ ] I receive public assistance or supplemental social security income.

DOS 1444-a (Rev. 1/14)

Page 5 of 6

Barber Apprentice Application

Applicant Affirmation — I affirm, under the penalties of perjury, that the statements made in this application are true and correct. I further affirm that I have read and understand the provisions of Article 28 of the General Business Law and the rules and regulations promulgated thereunder.

Applicant’s Signature

X

 

 

 

Date

 

 

 

 

 

Please remember to include with this form any required explanations and your

$20 applications fee (payable to the Department of State).

If you wish to pay by credit card, please visit our website at www.dos.ny.gov to obtain a credit card authorization form to complete and return with this application. It is important that you notify this division of any changes to your residence and

email address so you can continue to receive renewal notices and any

other notifications pertinent to your license.

NOTE: Please familiarize yourself with exam expectations by visiting our website.

DOS 1444-a (Rev. 1/14)

Page 6 of 6

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